Individual provider Active NPI

Corbin Miller

  • Chiropractor
  • Madison, WI
National Provider Identifier
1073215562
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6052-12 Issued in WI
Practice address
4535 Helgesen Dr
Madison, WI 53718-6747
Phone
(608) 441-0888
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6052-12 WI Primary

Addresses

Primary practice location

4535 Helgesen Dr
Madison, WI 53718-6747

Mailing address

822 E Washington Ave Apt 510
Madison, WI 53703-6503
Phone (402) 201-5709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204004044 PA Practitioner - Chiropractic 4981134095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 E Montgomery Ave
Ardmore, PA 19003-2421
Phone (484) 393-7158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6052-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of PA PC Chiropractor CurrentSince Jan 15, 2025 Accepting new patients

Locations

40 E Montgomery Ave
Ardmore, PA 19003
Phone (484) 393-7158

700 E Swedesford Rd
Wayne, PA 19087
Phone (484) 254-7024

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1073215562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 E WASHINGTON AVE APT 510",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537036503",
            "telephone_number": "402-201-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 HELGESEN DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537186747",
            "telephone_number": "608-441-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CORBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6052-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.